The
Anti-Kickback Statute prohibits any person or business
entity including hospitals from making or accepting
payment to induce or reward any person for referring,
recommending or arranging for the purchase of any item
or service for which payment may be made under a
federally-funded health care program. The statute
prohibits kickbacks, bribes, inducements, rewards, and
other economic incentives that induce physicians to
refer patients for services or recommend purchase of
medical supplies that will be reimbursable under
government health care programs. Violations of the
Anti-Kickback Statute can be the basis of Medicare and
Medicaid Fraud Whistleblower Reward Lawsuit which offer
large rewards to medical professionals who properly
expose significant fraud.

If you are a healthcare professional
who is aware of illegal kickbacks, bribes, inducements,
rewards, or other economic incentives being paid by
hospitals to physicians for significant referrals of Tricare,
Veterans' Administration (VA), Medicaid, or Medicare
patients and are interested in a confidential review of
your a potential case,
please feel free to contact Hospital Kickback Lawyer Lawyer Jason Coomer via e-mail message
or our
submission form about a potential upcoding,
illegal kickback, bill padding, double billing, or
billing fraud qui tam lawsuit.

The Anti-Kickback Statute "Safe
Harbor" Provisions

Because the Anti-Kickback Statute was
initially broad on its face, concerns arose among health
care providers that some beneficial commercial
arrangements were prohibited. Responding to these
concerns, Congress authorized "safe harbors" for various
payment and business practices that, while potentially
prohibited by the law, would not be prosecuted.

The Antikickback Statute contains
certain exceptions or "safe habors", which allow conduct
that would otherwise violate the statute including
allowing the Secretary of Department of Health and Human
Service to promulgate regulations which identify
practices which do not violate the Antikickback Statute.
Some of these safe habors can be found at 42 C.F.R. �
1001.952.

The Anti-Kickback Statute and the Stark Statute

The Stark Statute is named after
California Rep. Pete Stark who authored this
legislation. The purpose of the law is to prohibit
physician self-referrals and prevents a physician from
referring patients for certain designated health
services to any entity with which the physician has a
financial interest.. The law applies to any physician
who provides care to Medicare or Medicaid and is not as
broad as the Anti-Kickback Statute.
The Anti-Kickback Statute and Stark Statutes are
separate statutes, but are also refer to one another,
sometimes making compliance with one contingent on
complying with the other. Both are intended to prevent
health care providers from making referrals for the
purpose of financial benefit to themselves instead of
for the patient's benefit.

For more information on the Stark
Statute or Federal False Claim Lawsuits from violations
of the Stark Statute, go to the following webpage on
Stark Statute Violation False Claim Lawsuits.

Through the Federal False
Claims Act The United States Has Recovered Over $50
Billion

Since 1986, the Civil Division of the
Department of Justice, working with U.S. Attorneys
across the country, has returned tens of billions of
dollars to the federal Treasury through civil and
criminal judgments and resolutions in affirmative cases.
This amount includes more than $53.6 billion recovered
by the Division and the U.S. Attorneys under the False
Claims Act. Last year alone, the government recovered
more than $4.7 billion under the Act—the seventh
straight year that the Department has recovered more
than $3 billion of taxpayer funds. Similarly, in each of
the last seven fiscal years, the government’s health
care fraud recoveries have equaled or exceeded $2
billion. In addition, in FY 2016, the government
recovered more than $6.6 billion from banks and other
financial institutions making false statements and
claims.

Medicaid, Tricare, Veterans
Administration, Hospice, and Medicare Whistleblowers
that provide original source information of schemes to
fraudulently take money from our United States
government including illegal kickbacks, bribes, upcoding, double billing, bill
padding, unbundling, and charging for services never
provided may recover a portion of the proceeds recovered
on the government's behalf. Below is an excerpt from the False
Claims Act explaining what types of awards qui tam
whistleblowers may recover for being the "original
source" of information that is used to successfully
expose fraud against Medicaid, Tricare, Veterans
Administration, Hospice, Medicare, or another
subdivision of the United States Government and recover
money from the parties committing the fraud.

(d) AWARD TO QUI TAM PLAINTIFF

(1) If the Government proceeds with
an action brought by a person under subsection (b), such
person shall, subject to the second sentence of this
paragraph, receive at least 15 percent but not more than
25 percent of the proceeds of the action or settlement
of the claim, depending upon the extent to which the
person substantially contributed to the prosecution of
the action. Where the action is one which the court
finds to be based primarily on disclosures of specific
information (other than information provided by the
person bringing the action) relating to allegations or
transactions in a criminal, civil, or administrative
hearing, in a congressional, administrative, or
Government [General] Accounting Office report, hearing,
audit, or investigation, or from the news media, the
court may award such sums as it considers appropriate,
but in no case more than 10 percent of the proceeds,
taking into account the significance of the information
and the role of the person bringing the action in
advancing the case to litigation. Any payment to a
person under the first or second sentence of this
paragraph shall be made from the proceeds. Any such
person shall also receive an amount for reasonable
expenses which the court finds to have been necessarily
incurred, plus reasonable attorneysâ€™ fees and costs. All
such expenses, fees, and costs shall be awarded against
the defendant.

(2) If the Government does not
proceed with an action under this section, the person
bringing the action or settling the claim shall receive
an amount which the court decides is reasonable for
collecting the civil penalty and damages. The amount
shall be not less than 25 percent and not more than 30
percent of the proceeds of the action or settlement and
shall be paid out of such proceeds. Such person shall
also receive an amount for reasonable expenses which the
court finds to have been necessarily incurred, plus
reasonable attorneysâ€™ fees and costs. All such expenses,
fees, and costs shall be awarded against the defendant.

Since amendments were made to the
Federal False Claims Act in 1986, citizens that have
filed suits on behalf of the federal government against
government contractors that have participated in
defrauding the government have regained over $12 Billion
for taxpayers as well as have collected over $1 Billion
in qui tam whistleblower awards.

Medicare and Healthcare Fraud Law Suits (Qui
Tam Claims)

HEALTH CARE FRAUD CASE NETS RECOVERY
OF $1.7 BILLION

HCA Inc. (formerly known as
Columbia/HCA and HCA - The Healthcare Company) and HCA
subsidiaries agreed to pay the United States over $1.7
Billion including $631 million in 2003 for civil
penalties and damages arising from false claims the
government alleged it submitted to Medicare and other
federal health programs. In 2000, HCA subsidiaries pled
guilty to substantial criminal conduct and paid more
than $840 million in criminal fines, civil restitution
and penalties. HCA will pay an additional $250
million to resolve overpayment claims arising from
certain of its cost reporting practices. In total,
the government will have recovered $1.7 billion from
HCA.

This Qui Tam settlement resolved
fraud allegations against HCA and HCA hospitals in nine
False Claims Act qui tam or whistleblower lawsuits
pending in federal court in the District of Columbia.
Under the federal False Claims Act, private individuals
may file suit on behalf of the United States and, if the
case is successful, may recover a share of the proceeds
for their efforts. Under the HCA settlement, the
whistleblowers will receive a combined share of
$151,591,500.00.

Whistleblower Protection Under the Federal
False Claims Act

Under Section 3730(h) of the False
Claims Act, "[a]ny employee who is discharged, demoted,
suspended, threatened, harassed, or in any other manner
discriminated against in the terms and conditions of
employment by his or her employer because of lawful acts
done by the employee on behalf of the employee or others
in furtherance of an action under this section,
including investigation for, initiation of, testimony
for, or assistance in an action filed or to be filed
under this section, shall be entitled to all relief
necessary to make the employee whole. Such relief shall
include reinstatement with the same seniority status
such employee would have had but for the discrimination,
2 times the amount of back pay, interest on the back
pay, and compensation for any special damages sustained
as a result of the discrimination, including litigation
costs and reasonable attorneys' fees. An employee may
bring an action in the appropriate district court of the
United States for the relief provided in this
subsection."

For more information on Whistleblower Protection Under
the Federal False Claims Act or other Federal
Whistleblower Protections, please go to the following
Whistleblower Protection Webpage.

If you are aware of a large health care
company or individual that is defrauding the United States
Government, Tricare, Medicare, Veterans' Administration
(VA), or Medicare out of millions or billions of dollars,
contact
Medicare, VA, Tricare Fraud Whistleblower Lawyer Jason
Coomer via e-mail message Jason Coomer. As a
Veterans' Administration, Tricare, Medicaid, Hospice, and
Medicare Fraud Whistleblower Lawyer, he works with other
powerful qui tam lawyers that handle large Health Care
Government Fraud cases. He works with San Antonio
Veterans' Administration Fraud Whistleblower Lawyers, Dallas
Medicare Fraud Lawyers, Houston Medicare Upcoding Fraud
Lawyers, and other Texas Health Care Kickback Fraud Lawyers
as well as with other Medicare and Health Care Fraud Lawyers
throughout the nation to blow the whistle on fraud that
hurts the United States.